Advocates argue that euthanasia for children, with the consent
of their parents, is necessary to give families an option in a
desperately painful situation. But opponents have questioned whether
children can reasonably decide to end their own lives.
already a euthanasia pioneer; it legalized the practice for adults in
2002. In the last decade, the number of reported cases per year has
risen from 235 deaths in 2003 to 1,432 in 2012, the last year for which
statistics are available. Doctors typically give patients a powerful
sedative before injecting another drug to stop their heart.
Only a few countries have legalized euthanasia or anything approaching it.
the Netherlands, euthanasia is legal under specific circumstances and
for children over the age of 12 with parental consent. (There is an
understanding that infants, too, can be euthanized, and that doctors
will not be prosecuted if they act appropriately.) Elsewhere in Europe,
euthanasia is only legal in Luxembourg. Assisted suicide, where doctors
help patients to die but do not actively kill them, is allowed in
In the U.S., the state of Oregon grants
assisted suicide requests for residents aged 18 or over with a terminal
illness. Assisted suicide also is allowed in the states of Washington,
Vermont and Montana.
In Belgium, the ruling Socialist party has
proposed the bill expanding the right of euthanasia. The Christian
Democratic Flemish party vowed to oppose the legislation and to
challenge it in the European Court of Human Rights, if it passes. A
final decision must be approved by Parliament and could take months.
In the meantime, the Senate has heard testimony on both sides of the issue.
“It is strange that minors are considered legally incompetent in key
areas, such as getting married, but might (be able) to decide to die,”
Catholic Archbishop Andre-Joseph Leonard testified.
alternatives like palliative sedation make euthanasia unnecessary — and
relieves doctors of the burden of having to kill patients. In palliative
sedation, patients are sedated and life-sustaining support is withdrawn
so they starve to death; the process can take days.
But the debate has extended to medical ethicists and professionals far from Belgium.
Charles Fostr, who teaches medical law and ethics at Oxford University,
believes children couldn’t possibly have the capacity to make an
informed decision about euthanasia since even adults struggle with the
“It often happens that when people get into the
circumstances they had so feared earlier, they manage to cling on all
the more,” he said. “Children, like everyone else, may not be able to
anticipate how much they will value their lives if they were not
others, though, who argue that because Belgium has already approved
euthanasia for adults, it is unjust to deny it to children.
“The principle of euthanasia for children sounds shocking at
first, but it’s motivated by compassion and protection,” said John
Harris, a professor of bioethics at the University
of Manchester. “It’s unfair to provide euthanasia differentially to
some citizens and not to others (children) if the need is equal.”
And Dr. Gerlant van Berlaer, a pediatric oncologist at the
Universitair Ziekenhuis Brussels hospital, says the changes would
legalize what is already happening informally. He said cases of
euthanasia in children are rare and estimates about 10 to 100 cases in
Belgium every year might qualify.
“Children have different ways
of asking for things, but they face the same questions as adults when
they’re terminally sick,” van Berlaer said. “Sometimes it’s a sister who
tells us her brother doesn’t want to go back to the hospital and is
asking for a solution,” he said. “Today if these families find
themselves (in that situation), we’re not able to help them, except in
dark and questionable ways.”
The change in the law regarding people with dementia is also controversial.
now can make a written declaration they wish to be euthanized if their
health deteriorates, but the request is only valid for five years and
they must be in an irreversible coma. The new proposal would abolish the
time limit and the requirement the patient be in a coma, making it
possible for someone who is diagnosed with Alzheimer’s to be put to
death years later in the future.
In the Netherlands, guidelines allow doctors to euthanize dementia patients on this basis if they believe the person is experiencing “unbearable suffering,” but few are done in practice.
Patrick Cras, a neurologist at the University of Antwerp, said people
with dementia often change their minds about wanting to die.
“They may turn into different people and may not have the same feelings
about wanting to die as when they were fully competent,” he said. “I
don’t see myself killing another person if he or she isn’t really aware
of exactly what’s happening simply on the basis of a previous written
request (to have euthanasia). I haven’t fully made up my mind but I
think this is going too far.”
Penney Lewis, a professor and
medical law expert at King’s College London, agreed that carrying out
euthanasia requests on people with dementia once they start to worsen could be legally questionable.
“But if you don’t let people make decisions that will be respected in
the future, including euthanasia, what you do is encourage people to
take their own life while they have the capacity or to seek euthanasia
much earlier,” she said.
In the past year, several cases of
Belgians who weren’t terminally ill but were euthanized — including a
pair of 43-year-old deaf twins who were going blind and a patient in a
botched sex change operation — have raised concerns the country is
becoming too willing to euthanize its citizens. The newest proposals
have raised eyebrows even further.
“People elsewhere in Europe
are focused on assisted dying for the terminally ill and they are
running away from what’s happening in Belgium,” Lewis said. “If the
Belgian statutes go ahead, this will be a key boundary that is crossed.”